Category Archives: Soapbox

#LISmentalhealth week is in February. In the past, I’ve been around but not really present to it. I am no stranger to mental health challenges, both my own and other’s, but I haven’t felt ready to talk about my challenges, and other’s stories aren’t mine to tell.

But then this year happened. It had some really great parts, but it was one of the hardest years of my life, and it came on the heels of another very challenging year. So, basically, it’s been a few years, and it’s been rough. Among the many other things that have contributed to this recent hard patch, my physical health has taken a serious beating. The high points of that battle include a seriously restrictive therapeutic diet, a recurrence of Epstein-Barr (my second in 5 years), and an emergency appendectomy that led to a few previously undiscovered drug allergies. My mental health reached a low point right around the time of #lismentalhealth week this year. I serendipitously found Jen Gotch’s emotional rating system and identified strongly with the numbers at the lower end, which prompted me to seek help. I overcame what felt like nearly insurmountable challenges (my sick mind and my sick body) to find a therapist, and I spoke with my doc about medication options. I started taking 5HTP, an OTC seratonin precursor. I started therapy. I serendipitously listened to an episode of On Being called The Soul in Depression and from there read parts of Andrew Solomon’s The Noonday Demon. As my therapist notes, my way of understanding the world is through my intellect. I started to feel better.

And then this spring Kate Spade and Anthony Bourdain killed themselves. The public rhetoric surrounding suicide goes something like this: “If you’re sad just reach out for help. People want to help you. *hotline phone numbers*.” It enrages me. Surely, the heart of the rhetoric is true as far as it goes, but it completely misses the point. First of all, deeply depressed people aren’t sad, not really. My own, relatively mild, experience with depression is reflected in Andrew Solomon’s definition of depression:

It’s an experience, I think, overall, of finding the most ordinary parts of life incredibly difficult: finding it difficult to eat, finding it difficult to get out of bed, finding it difficult and painful to go outside; being afraid all of the time and being overwhelmed all the time. And frequently, it’s quite a sad experience to be afraid and overwhelmed all the time; nonetheless, those are the essential qualities of it. It isn’t, I think, primarily an experience of sadness.

And secondly, what would you have people do who can’t afford longterm help, or whose health insurance has run out and therefore can’t continue treatment? The pleas to find help transfer the responsibility of finding help to the depressed, in the exact moment when picking up the phone feels most impossible. The rhetoric isn’t wrong, it’s just unhelpful, and it displays a systematic misunderstanding of mental health.

There’s plenty of political lobbying we could and should do surrounding mental health, and just health in general. My feelings about the US healthcare system are complicated. Frankly, many of them are extremely angry. Until recently, I hadn’t sorted through those feelings to feel like I had something I wanted to say about #lismentalhealth, but in light of my year(s), and with Kate Spade and Anthony Bourdain as my catalyst, I have something to say about it today. It’s this:

Find a therapist you trust and establish a relationship while you’re feeling fine(ish).

Make a promise to yourself to go to for a regular checkup with your therapist, whether this is every 6 months or more frequently.

Keep your promise.

Tell others about your mental health maintenance.

When/if you move, treat setting up your therapist the same way you treat the necessity of finding a general practitioner and dentist. It is equally important.

I’m not naive enough to think this is a perfect solution, but it is something. This is mental wellness maintenance, a support of continuing health for the healthy. It’s not sexy, and it doesn’t come with a triumphant story. It’s decidedly work-a-day, but it would be transformative for our culture if even 50% of the population did this. Why not you?

For those with health insurance, many workplaces offer an Employee Assistance Program, which covers a certain number of sessions with a mental health worker per year. Both at my previous place of employment (with really marginal health insurance) and at my current place of employment (with really excellent health insurance), I was covered for 6 sessions per year. Use them, and the maintenance of your mental health will cost you no more out of pocket than your yearly physical and bi-yearly dental cleaning. Because this I know: When you most need a therapist it will be most impossible to overcome your mental state to find one. Find one now, and you’ll have someone to call when you really need it. Treat your mental health like you treat your physical health. Get it checked regularly and don’t hide the maintenance from others.